HighlightsAn unrecognised iatrogenic thoracic duct chyle leak carries significant morbidity and mortality.A case of chylothorax post oesophagectomy, treated by interventional radiology, is described.Lymphangiography identified aberrant thoracic ductal anatomy.Coiling and embolization following ductal injury is safe, effective and less morbid procedure.
Oedema can occur in handled tissues following upper gastrointestinal surgery with anastomosis formation. Obstruction of the lumen may result in delayed return of enteric function. Intravenous steroid use may be beneficial. Three cases of delayed emptying following fundoplication, gastro-enteric and entero-enteric anastomoses are reviewed. Conservative management with supportive measures failed. Dexamethasone was administered to treat the oedematous obstruction. A literature review in PubMed, Cochrane database and Medline for English language publications on the use of dexamethasone in the treatment of acute post surgical oedema of the upper gastrointestinal was conducted. Administration of dexamethasone led to resolution of symptoms and successful outcome. No reports on the use of steroids in this context were identified in the literature. The use of dexamethasone may effectively treat intestinal obstruction due to inflammatory or oedematous cause in the early post-operative period.
The importance of long−term follow−up of oesophageal cancer has increased due to improved survival [1] and increased inci− dence. We describe a patient whose case raises a number of important issues re− garding surveillance.
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